ABOUT THE EPISODE
In the episode, Dr. Laila Agrawal discusses how she first became interested in this field – a patient’s distress over the loss of libido after cancer treatment inspired her to learn more, as medicine rarely prioritizes female sexual pleasure.
HERE’S WHAT WE DISCUSS
- Breast cancer treatment can profoundly impact sexuality in biological, psychological, and social ways. Understanding each facet is essential. Surgery, radiation, chemo, and hormone therapy all have sexual side effects. Body image issues and relationship challenges often emerge, too.
- Despite fear and urgency around diagnosis, there IS time to thoughtfully consider surgical options like mastectomy vs lumpectomy and weigh impacts on sensation and body image. Removing unaffected breast tissue does NOT improve cancer survival rates or reduce recurrence risk.
- Vaginal estrogen is considered safe for most breast cancer survivors and can effectively treat genitourinary issues like dryness, pain, and libido. Those on aromatase inhibitors require nuanced risk/benefit conversations first. Vaginal DHEA can be an alternative.
- The American Congress of Obstetricians and Gynecologists has a position statement on the use of vaginal estrogen after treatment for breast cancer.
- For low desire, non-hormonal medications like filbanserin and bremelanotide can help in some cases, but sex therapy and addressing lifestyle factors should come first. Pelvic floor physical therapy is also hugely beneficial for many.
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